Can physician leadership be taught and measured, and does the type of program matter? That question guided the research behind this doctoral thesis, attained while the primary author was serving as a senior executive at a major healthcare organization and pursuing a Doctor of Business Administration.(1)
At the request and with the support of a hospital system’s leadership, we planned and conducted a multi-month study comparing two approaches to physician leadership training: one traditional and homogenous (composed solely of physicians), and one inter-professional (including physicians, nurses, and administrators).
This first article in the series serves as a summary of that research — a high-level overview of the study’s design, outcomes, and implications for those seeking to strengthen leadership across the continuum of care. In subsequent issues of the Physician Leadership Journal, we will provide additional insights into four key findings from the study:
Measuring Leadership Growth Using Defined Metrics
The Inter-Professional Advantage in Developing Physician Leaders
The Surprising Impact on Physician Burnout
Growth in the Words of the Physician Attendees
These findings suggest practical and measurable pathways for leadership development in healthcare. In a time of growing system complexity, clinician stress, and workforce transformation, they offer healthcare leaders a data-informed guide for building effective, adaptive, and collaborative teams.
STUDY DESIGN AND DATA COLLECTION
The study involved 85 physicians divided between two course formats: a homogenous group composed of 50 physicians (mixed specialties) and an inter-professional education (IPE) group that included 35 physicians (also of mixed specialties, with the same percentage as found in the first group), 10 nurses, and five executive administrators. The goal was to measure change in leadership attributes, communication, and information exchange across a six-month leadership development program and compare the outcomes in each group.
Multiple data sources were used to assess these changes, including:
Self-assessments from physicians (pre- and post-course).
Feedback about physician students from peer physicians, nurses, and partners/spouses.
Four targeted survey items about burnout, added at the hospital’s request.
Qualitative reflections submitted voluntarily by physician participants midway through the program.
To ensure data reliability, internal consistency was assessed using Cronbach’s alpha, a commonly used statistical measure of scale reliability.(2) Most categories achieved acceptable to excellent reliability, apart from the “communication” category, which may have been affected by specialty-specific language differences among participants.
KEY FINDINGS
1. Leadership Self-Awareness Increased Significantly
All participants showed statistically significant improvement in their self-assessment scores related to leadership, communication, and information exchange. This suggests that both homogenous and IPE formats can effectively support leadership development.
2. Inter-Professional Training Strengthened External Alignment
While both groups improved, the IPE cohort demonstrated a particularly important gain: greater alignment between how participants rated themselves and how others who observed their approach to leading — peer physicians, nurses, and their spouses/partners — rated the participants’ change. While both groups improved in the measured areas, the IPE participants became more self-aware and more accurately perceived by those around them.
This convergence of self-perception and external feedback is a hallmark of mature leadership development. It suggests that learning in a mixed professional context may offer additional benefits in building interpersonal trust and cross-disciplinary collaboration.
3. Physician Burnout Declined — Without Direct Intervention
Although burnout was not an explicit focus of the leadership curriculum, the healthcare system asked that we also measure pre- and post-survey results on the physicians’ perceived burnout. All participants showed reduced scores on the four burnout-related questions, adapted from the Maslach Burnout Inventory.(3)
Participants in the IPE group experienced a slightly larger decrease, although the difference was not statistically significant. This finding suggests that leadership development itself — particularly training that reinforces purpose, character, communication, and relational trust — may serve as an indirect but powerful tool for mitigating emotional exhaustion, cynicism, and disengagement.(4)
CORRELATIONS AND BEHAVIORAL SHIFTS
Further analysis revealed several noteworthy patterns:
Pre-course correlations between physician self-perception and external ratings from chosen evaluators were low or even negative — especially between physicians and nurses (physicians tended to rate their leadership skills higher than their peer nurses). Post-course, those correlations improved significantly, particularly among IPE participants.
Ratings from partners/spouses also showed a marked improvement in alignment with participant self-assessments after the course, suggesting that leadership growth extended beyond the workplace and into personal relationships.
Qualitative comments highlighted increased confidence, clarity, and appreciation for inter-professional teamwork — particularly among those in the IPE group. (This area will be the highlight of article five in this series.)
These reflections were examined using grounded theory techniques outlined by Strauss and Corbin(5) and incorporated into a mixed-methods framework informed by Creswell.(6)
IMPLICATIONS FOR HEALTHCARE LEADERS
The study’s most compelling insight is not just that leadership training works, but also that the way organizations design and conduct that training matters. Creating an outcomes-based learning environment that brings together individuals from different professional backgrounds can accelerate growth, build mutual respect, and cultivate more collaborative leadership.
This has direct implications for hospitals, health systems, and medical educators seeking to equip future physician leaders. Programs that emphasize inter-professional education appear to offer a measurable advantage — not only in leadership capacity, but also in engagement, well-being, and cultural cohesion.
CONCLUSION
The results from this comparative study — which will be the focus of the next article on metrics — offer more than theoretical value. They suggest actionable strategies for designing programs that will shape the next generation of healthcare leadership. In a field where outcomes are paramount and human connection is central, fostering self-awareness, inter-professional collaboration, and measured growth is not just beneficial — it is essential.
The next four articles in this series will explore each theme — metrics, collaboration, burnout, and some thoughts from the participants — in greater detail, with additional references, offering healthcare leaders concrete insights drawn from real-world application and academic rigor.
[Editor’s Note: This is the first article in a series presented by PLJ. The five articles —published over the next five issues of PLJ —will highlight an overview of the study, the metrics used during the research, the advantages demonstrated during the inter-professional program, an unexpected outcome of the study regarding physician burnout, and remarks from participating physicians on what they learned about individual and team leadership.]
References
Hertling M. Physicians Must Lead! A Comparative Study of Two Approaches to Physician Leader Development. DBA diss., Rollins College, 2019: 1–111.
Tavakol M, Dennick R. Making Sense of Cronbach’s Alpha. Int J Med Educ. 2011; 2:53–55. https://doi.org/10.5116/ijme.4dfb.8dfd
Maslach C, Jackson SE. The Measurement of Experienced Burnout. J Occu Behav. 1980; (2):99–113. https://doi.org/10.1002/job.40300 20205
Swenson S, Kabcenell A, Shanafelt T. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. J Healthc Manag. 2016; 61(2):105–127. https://doi.org/10.1097/00115514-201603000-00008
Strauss A, Corbin J. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage;1990.
Creswell JW. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Sage; 2009.